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纵隔穿透性枪伤合并血流动力学稳定的孕妇。

Transmediastinal Gunshot Wound in a Pregnant Patient with Stable Hemodynamics.

机构信息

Department of Obstetrics and Gynecology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey.

Department of Obstetrics and Gynecology, University of Health Sciences, Ministry of Health Ankara City Hospital, Ankara, Turkey.

出版信息

Rev Bras Ginecol Obstet. 2021 Feb;43(2):145-147. doi: 10.1055/s-0040-1715142. Epub 2021 Jan 19.

Abstract

Transmediastinal gunshot wounds (TGWs) may lead to life-threatening injuries of vital organs such as large vessels, the esophagus, and lungs. Although they are not commonly encountered in pregnant women, additional caution should be given to these patients. Physical examination for the diagnosis and the choice of treatment modality contain controversial points in hemodynamically stable patients, and resuscitation has excessive importance due to physiological changes in pregnancy. We present a hemodynamically stable 26-week pregnant woman brought to the emergency department for TGW. She had a 1-cm diameter of bullet entrance hole on the right anterior 4 intercostal space, 2 cm lateral to the sternum, and a 3-cm diameter exit hole on the right posterior 12 intercostal space on the midscapular line. With our conservative approach, she had an uncomplicated pregnancy period, and gave birth to a healthy baby at term.

摘要

经纵隔枪伤(TGW)可导致大血管、食管和肺部等重要器官的危及生命的损伤。虽然 TGW 在孕妇中并不常见,但对这些患者应格外小心。对于血流动力学稳定的患者,体格检查和治疗方式的选择存在争议点,由于妊娠的生理变化,复苏具有重要意义。我们介绍了一位血流动力学稳定的 26 周孕妇,因 TGW 被送到急诊室。她右侧第 4 肋间前胸骨旁 1cm 处有 1cm 直径的子弹入口孔,胸骨旁 2cm 处有 3cm 直径的出口孔,位于肩胛线的第 12 后肋间。采用我们的保守治疗方法,她顺利度过了孕期,并足月产下了一个健康的婴儿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a80/10183918/03616be782f3/10-1055-s-0040-1715142-i200115-1.jpg

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